The difficulties faced by Egyptian physicians could mount tomorrow, when pro-democracy forces are hoping to mobilize a million people for a giant protest.

The difficulties faced by Egyptian physicians could mount tomorrow, when pro-democracy forces are hoping to mobilize a million people for a giant protest.

"It will be one of the most important days in our history," said Mohamed Selim, MD, a surgeon at Cairo's Ain Shams University Hospital.

But he and his colleagues will not be in the streets -- they'll be where they've been for days, tending the injured at one of the two main downtown hospitals in the Egyptian capital.

In an interview with MedPage Today/ABC News, Selim painted a picture of sudden and frantic need, all but overwhelming his emergency room, followed by relative calm as the tide of events swept past.

"The worst day was Friday (Jan. 28)," Selim said. "We had a gush of gunshots, stab wounds, crashes, people hit by stones, a lot of post-concussions, a lot of mortalities -- about 25 to 30 mortalities -- and a lot of people admitted to the hospital."

On a normal day, the emergency room at Ain Shams can handle between 20 and 30 patients; on Friday, they had more than 200 and the following day another 70, Selim said.

Today, in contrast, "was not that bad," Selim said -- only a single gunshot wound and a few other miscellaneous injuries. That was largely because the roads and bridges leading to the hospital were closed, forcing the injured to go to other institutions.

But, Selim added, colleagues working in Tahrir Square, the center of the protests, are reporting many casualties and a growing shortage of supplies.

While the emergency wards are packed, day-to-day medical practice in Cairo is also suffering serious dislocation, other doctors said.

Surgical oncologist Mohamed Shaalan, MD, of Cairo University, said operating rooms at the National Cancer Institute hospital in Cairo are closed, partly because nursing staff and technicians are having difficulty getting to work.

Shaalan told MedPage Today/ABC News that "today was the first day I operated on a cancer patient after a week of not being able to operate."

He also removed a bullet from the scalp of a 23-year-old man, the son of friends, who was struck in the head as he tried to run from security forces. Shaalan did the procedure in a small private Cairo hospital.

He added that many diagnostic labs are closed and tests are being postponed.

Cardiologist Adel Allam, MD, of Al-Azhar University in Cairo told MedPage Today/ABC News that all nuclear medicine studies in the country have been cancelled because the needed isotopes can't be cleared through the airport.

Normally, he said, they are transported in police cars to Egypt's atomic energy agency, where they're cleared and then sent to hospitals, but because of the unrest there are no police available for the task.

"Medical care has been disrupted to a big extent," Allam said. Aside from the difficulty of getting to work, patients themselves are not coming.

"Because of the curfew and the situation, the private places, like private radiology centers, they are not getting the usual flow of patients, and most of them are closed," he said.

Another obstacle is money: The banks are closed and since patients must pay cash, many can't get care -- except in an emergency.

At Ain Shams, Selim credits a U.S.-sponsored program for helping his colleagues cope with the crush of injured patients.

For the past six years, the University of Maryland's National Study Center for Trauma and EMS has been working with doctors at Ain Shams to build their skills in injury prevention research.

The collaboration led to the development of a course for the care and evaluation of injured patients, dubbed Sequential Trauma Educational Programs (STEPS), according to Jon Mark Hirshon, MD, of the University of Maryland.

When the crunch hit last week, Selim said, residents who had been through the course "were taking the lead during the mass casualties. They knew what to do -- how to deal with the patients, how to triage them, and how to manage them."

"And really, they saved a lot of lives."

The Ain Shams hospital and the Kasr El Aini hospital (associated with Cairo University) are modern facilities with well trained doctors and staff, Hirshon said, but they have been overwhelmed in recent days.

"But even in the U.S., if you're getting hundreds of people injured, you're going to be overwhelmed," he said.

One advantage the Egyptian physicians may have is that they are used to dealing with trauma, he said. "There's a lot of morbidity from accidents, mainly car crashes," he said.

And, of course, they've been getting a lot of practice in recent days.

"On Sunday I was there for 24 hours, and we had about 15 people with gunshots and thanks to God no mortalities," Selim said. "We had seven operations, and for the others we removed gunshots from their upper and lower limbs. It was a very good day."

"We were exhausted but we know we are doing something for our country so we are proud of what we are doing," he added. There was an attempt to establish a shift rotation, he said, "but all of us refused -- we wanted to stay to help anyone who's coming, shot or injured."

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